Insurance Verification & Authorizations Specialist

Job Description

Job Description

Insurance Verification & Authorizations Specialist

Ambulatory Surgery Center 

Location: Onsite – DFW Area
Position Type: Full-Time | Healthcare Revenue Cycle

Position Summary

We are seeking an experienced Insurance Verification & Authorizations Specialist to manage front-end revenue cycle functions for an ambulatory surgery center and pain management practice. This onsite role is critical to ensuring accurate benefits verification, timely prior authorizations, and proactive follow-up across multiple payers and portals.

Key Responsibilities

• Verify insurance eligibility, benefits, deductibles, co-insurance, and out-of-pocket maximums

• Obtain and track prior authorizations for surgical, interventional pain, and diagnostic procedures

• Perform authorization follow-up to ensure approvals are received prior to date of service

• Navigate and manage all major payer online portals (Medicare MACs, Medicaid, BCBS, UHC, Aetna, Cigna, Tricare, etc.)

• Enter and maintain accurate authorization and benefit data within HST Pathways

• Communicate authorization requirements and financial responsibility clearly to staff and patients

• Escalate delayed or denied authorizations and document outcomes

• Maintain compliance with payer-specific rules and timelines

Required Qualifications

• Minimum 2–3 years experience in insurance verification and prior authorizations

• Hands-on experience with HST (HST Pathways) – required

• Strong working knowledge of ASC and pain management workflows

• Proven ability to use payer web portals efficiently and independently

• Familiarity with Medicare, Medicaid, and commercial payer authorization rules

• High attention to detail and strong follow-through skills

• Ability to manage multiple cases simultaneously in a fast-paced environment

Preferred Qualifications

• Experience in an Ambulatory Surgery Center (ASC) setting

• Knowledge of interventional pain procedures, spine, ortho, or GI authorizations

• Prior experience working with Texas Medicaid and Medicare MACs

• Understanding of medical necessity and payer policy requirements

• Bilingual Spanish/English

What We Offer

• Competitive compensation based on experience

• Stable, physician-led practice environment

• Collaborative onsite team culture